YEMEN: AMIDST CONFLICT, WORLD BANK REACHES 1.5 MILLION CHILDREN WITH POLIO VACCINES

The crisis in Yemen has taken a heavy toll on the country's children, with thousands killed and thousands more at risk of disease and malnutrition.

All World Bank Group operations in Yemen were suspended when the conflict worsened, but a partnership with the United Nations Children's Emergency Fund (UNICEF) and the World Health Organization (WHO) has allowed for the continuation of key activities of two Bank-funded health projects.

The Health and Population Project has provided critical support for the national polio campaign that has managed to vaccinate 1.5 million Yemeni children despite the conflict.

"This is so critical to us. We cannot afford to lose another child!" With these words, Ashwak Althabibi, a 36 years old mother of 6 children, shared the story of losing her daughter Nora last year. "We couldn't get her to the hospital soon enough, and by the time we found transportation and reached the hospital, Nora was gone" she added with tearful eyes.

She composed herself to say, "I just want to thank the vaccination team for their perseverance. They come on a regular basis and vaccinate all my children. It's a great consolation for us to feel such care."

"No transportation can get there and it is the team's responsibility to reach this population and to make sure all their children get vaccinated during this hard time," commented Hana Ali Nagi, a 19-year-old health volunteer in the vaccination campaign.

Since the start of the current conflict, Yemen has suffered massive damage to infrastructure, such as hospitals and clinics, and the interruption of medical supplies. Many foreign health personnel have left, and even the most basic needs for a healthy existence-access to water, sanitation, and food-have become, for most Yemenis, a daunting, daily task.

Gone too are the days when the victims of war were mostly soldiers: the Yemeni conflict has been unfair to women and children, which means the most vulnerable Yemenis are bearing the brunt of the conflict.

Thousands of Yemeni children have been killed and injured in the war, and hundreds of thousands put at more risk of death from disease or malnutrition. UNICEF estimates that 320,000 children in Yemen face severe malnutrition, while 2.2 million are in urgent need of humanitarian aid to prevent their nutritional status from deteriorating.

The last two decades have been a prolonged period of political instability and economic fragility in Yemen, a country with both limited natural resources and an underdeveloped institutional capacity for project implementation.

But one lesson from previous World Bank Group experience in the health sector, is that government ownership, simple project design, and donor coordination should come top of the list of ways to make things work.

Yemen's Health and Population Project (HPP) has a simple, evidence-based outreach delivery model for health services in coordination with UNICEF and WHO, in order to procure some of the essential medications and medical supplies needed for the outreach campaigns.

This has enabled the Bank to continue its support to the project, when the war escalated and the Bank's whole portfolio in Yemen was suspended, through channeling grants from the International Development Association (IDA - the World Bank's fund for the world's poorest countries) directly to UNICEF and WHO to deliver vaccinations and basic health services such as nutrition and reproductive health to children and women, respectively.

Since the project's activities resumed in January 2016, around 1.5 million Yemeni children under 5 years old were reached by the national polio campaigns supported by the project, which represents about 30 percent of the whole target population nationwide.

"Conflict can have devastating, multi-generational impacts, but by leveraging our partnerships in Yemen, we are able to continue investing in children's health, which is a vital investment in the country's future," said Asad Alam, World Bank Country Director for Egypt, Yemen and Djibouti.

The outreach model aims to reach children in remote areas that are hard to get to. It will continue to operate this way until the foundations of the country's public health system are back in place. Simple, ready-to-go interventions are what Yemenis want to see as a practical response to their desperate need for basic health care. Health workers use different ways to deliver those services in such remote areas where camels, donkeys, or mountain climbing are usual means of transportation.

More outreach rounds for basic health services are planned, although the security situation prevents access to children in some areas. Overall, because of the problems of damaged infrastructure, fuel shortages, displacement and increased poverty, the simple outreach model of delivering basic health services is best suited to Yemen's present situation. A door-to-door health round gives children the chance of getting vaccinated at home, with health professionals and volunteers spreading out across the country, mobilizing communities and vaccinating children.

Hopefully, soon peace will mark a new chapter, both in the rebuilding Yemen and its health system, and improving the lives of all Yemenis and particularly its future, the children.

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